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Individual

MRS. CRYSTAL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT24804
FL
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J525104977040
DRIVERS LICENSE
FL
01
W230684178000
DRIVERS LICENSE
FL
Enumeration date
01/25/2023
Last updated
06/03/2026
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